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There is already compelling evidence to motivate all smokers to give up smoking. But pregnant smokers should be especially motivated, given the risks their smoking poses for their pregnancies and children. We know that during the parenting stage of life parents, (and, more specifically, pregnant women) are increasingly receptive to smoking cessation interventions due to their increased contact with health care systems and other facilities where smoking cessation can be encouraged. These are therefore the obvious sites for promoting awareness around tobacco use and fetal/child development.
While the literature on tobacco treatment supports widespread screening and treatment for smoking, pregnant women may need specific interventions along with self-help materials focusing on pregnancy issues. Research shows that quitting during the first trimester seems to provide the greatest benefits, but the positive effects of quitting at any time during pregnancy are also undeniable. Therefore, we should not only help pregnant women stay smoke-free from the time they make their first prenatal visit, but also throughout their pregnancy.
A variety of intervention designs have been used to increase parents’ motivation to quit smoking both during and after pregnancy:
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Practical counselling (including problem solving/skills training recalling past experiences at quitting, anticipating triggers, challenges to quitting)
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Printed self-help materials
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Telephone counselling
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Social support outside of treatment, supporting a partner’s efforts to quit, and receiving support from other family members, friends and co-workers
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Nicotine delivery systems that give intermittent rather than continuous exposure.
The abiding problem of investigation in this area remains how to identify smokers, especially pregnant smokers. Social pressure to not smoke during pregnancy can inhibit pregnant women from revealing their smoking status. Studies show high rates of deception (between 28% and 35%) when women are asked to self-report tobacco use and then are biochemically tested.
In fact, among the sizeable proportion of women who quit smoking for the duration of their pregnancy, rates of postpartum relapse are disappointingly high. Often the reasons for relapse can be found at home. Indeed, the presence of other smokers (i.e., an intimate partner or other family member) in the household has been shown to significantly increase the likelihood that smokers smoke during pregnancy and after giving birth.
Fortunately, there is ample evidence to support the effectiveness of treatment programs for pregnant and parenting smokers. Approximately 35% of pregnant women who quit smoking remain smoke free, improving their health as well as that of their children and other family members.
See also...
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